| Entity Name: | ST. CLOUD SMILES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Nov 2009 (15 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 12 Dec 2024 (2 months ago) |
| Document Number: | P09000095856 |
| FEI/EIN Number | 271358748 |
| Mail Address: | 1581 Amaryllis Circle, ORLANDO, FL, 32825, US |
| Address: | 2050 OLD HICKORY TREE RD., SUITE I, ST. CLOUD, FL, 34772 |
| ZIP code: | 34772 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023338597 | 2010-06-08 | 2010-06-08 | 2050 OLD HICKORY TREE RD, SUITE J, SAINT CLOUD, FL, 347728926, US | 2050 OLD HICKORY TREE RD, SUITE J, SAINT CLOUD, FL, 347728926, US | |||||||||||||||||||||||
|
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| Phone | +1 407-556-3969 |
Authorized person
| Name | MISS JENNIFER TRANG VAN |
| Role | OWNER |
| Phone | 9544838184 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN18003 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000333100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VAN JENNIFER T | Agent | 1581 AMARYLLIS CIRCLE, ORLANDO, FL, 32825 |
| Name | Role | Address |
|---|---|---|
| VAN JENNIFER T | President | 1581 Amaryllis Circle, ORLANDO, FL, 32825 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-12-12 | VAN, JENNIFER T | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-09-30 | 1581 AMARYLLIS CIRCLE, ORLANDO, FL 32825 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-30 | 2050 OLD HICKORY TREE RD., SUITE I, ST. CLOUD, FL 34772 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2023-10-31 | 2050 OLD HICKORY TREE RD., SUITE I, ST. CLOUD, FL 34772 | No data |
| REINSTATEMENT | 2012-01-06 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| ARTICLES OF CORRECTION | 2009-11-30 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-12-12 |
| Reg. Agent Change | 2024-09-30 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-05-30 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-11 |
| ANNUAL REPORT | 2017-05-02 |
| ANNUAL REPORT | 2016-04-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
